RUS Form 238-Construction for Equipment -Contract Amendment

form_238.pdf

New Equipment Contract (Form 395) for Telecommunications and Broadband Borrowers

RUS Form 238-Construction for Equipment -Contract Amendment

OMB: 0572-0149

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U.S. Department of Agriculture
Rural Utilities Service

CONSTRUCTION OR EQUIPMENT
CONTRACT AMENDMENT

2. Date

1. Borrower Designation

5. Bond Extension Attached

4. Contact No.

3. Amendment No.

YES

NO

6. Delivery or Completion Date

a. Original

b. As Amended

Instructions: 1. The Architect-Engineer shall submit three (3) copies of this form to the Owner.
2. If applicable, the Owner shall submit the three (3) copies of this form to RUS for approval.
7. Reasons for, and Details and Description of the Amendment
(If additional space is needed, use reverse or separate sheet)

8. A Summary Of the Original Contract Price and
Amendments thereto, Including this Amendment, follows:
(Amendments which decreased the price are preceded by a (-) minus sign.)
Original Contract Price

$

Amendment Number 1

$

Amendment Number 2

$

Amendment Number 3

$

Amendment Number 4

$

Amendment Number 5

$

Amendment Number 6

$

Amendment Number 7

$

Amendment Number 8

$

Amended Contract Price

$

This amendment, providing for an increase of $

/ decrease of $

in the contract price is submitted pursuant to the provisions of said contract. This Amendment does
, does not
,
require approval of the Administrator of RUS. To the extent the items hereof are approved, the contract shall be amended.
RECOMMENDED

Architect-Engineer

Date

ACCEPTED

Owner

Contractor

By

By
President

Date

President

Date

This Amendment must be signed with the full name of the Contractor. If the Contractor is a partnership, this Amendment must be signed in the
partnership name by a partner. If the Contractor is a corporation, this Amendment must be signed in the corporate name by a duly authorized
officer.

RUS Form 238 (Rev. 2-04)

1. Borrower Designation

2. Contract No.

CONSTRUCTION OR EQUIPMENT CONTRACT AMENDMENT (continued)
Item
No.

Changes in Cost (decrease preceded by (-) minus sign.)

Reason for and Description of Contract Amendment No.

Labor or
Installation

Material or
Equipment*

Total

$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
* To be completed when applicable.

RUS Form 238 (Rev. 2-04)


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File Modified2007-07-23
File Created2007-07-23

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